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Provider 1295861128

NPI: 1295861128Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$12.0M

$12,022,001

Total Claims

515K

Beneficiaries

429K

1.2 claims/patient

Avg Cost/Claim

$23

Monthly Spending Trend

Yearly Spending

2018
$1.8M
-12%
2019
$1.6M
-9%
2020
$1.4M
+10%
2021
$1.6M
+14%
2022
$1.8M
+10%
2023
$2.0M
-4%
2024
$1.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 26% of total spending.

99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$3.1M

57K claims · 25.6%

Your Cost: $54.08/claim|Median: $53.41
1.0× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$2.2M

61K claims · 17.9%

Your Cost: $35.34/claim|Median: $37.81
0.9× median
99393Normal range

Preventive medicine, established patient, age 5-11

$962K

15K claims · 8.0%

Your Cost: $63.45/claim|Median: $74.82
0.8× median
99212Normal range

Office/outpatient visit, low complexity

$952K

44K claims · 7.9%

Your Cost: $21.47/claim|Median: $25.06
0.9× median
99392Normal range

Preventive medicine, established patient, age 1-4

$844K

14K claims · 7.0%

Your Cost: $61.54/claim|Median: $75.18
0.8× median
99394Normal range

Preventive medicine, established patient, age 12-17

$835K

12K claims · 6.9%

Your Cost: $70.33/claim|Median: $80.15
0.9× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$567K

11K claims · 4.7%

Your Cost: $52.95/claim|Median: $69.35
0.8× median
99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$441K

5,850 claims · 3.7%

Your Cost: $75.34/claim|Median: $84.03
0.9× median
90472Normal range

Immunization administration, each additional vaccine

$385K

24K claims · 3.2%

Your Cost: $15.92/claim|Median: $11.79
1.4× median
90471Normal range

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$373K

29K claims · 3.1%

Your Cost: $12.94/claim|Median: $9.80
1.3× median
87426Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$322K

13K claims · 2.7%

Your Cost: $24.50/claim|Median: $30.04
0.8× median
99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$189K

3,594 claims · 1.6%

Your Cost: $52.53/claim|Median: $57.85
0.9× median
87804Normal range

Influenza virus detection, rapid test

$157K

21K claims · 1.3%

Your Cost: $7.63/claim|Median: $12.59
0.6× median
92551Normal range

Screening audiometry, pure tone, air only

$145K

20K claims · 1.2%

Your Cost: $7.31/claim|Median: $6.61
1.1× median
99051Normal range

$139K

9,956 claims · 1.2%

Your Cost: $13.99/claim|Median: $7.89
1.8× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$83K

9,963 claims · 0.7%

Your Cost: $8.32/claim|Median: $11.48
0.7× median
90473Normal range

Immunization admin, intranasal, first

$71K

7,964 claims · 0.6%

Your Cost: $8.87/claim|Median: $9.17
1.0× median
99395Normal range

Preventive medicine, established patient, age 18-39

$65K

1,069 claims · 0.5%

Your Cost: $60.58/claim|Median: $72.71
0.8× median
96110Normal range

Developmental screening, per standardized instrument

$51K

7,949 claims · 0.4%

Your Cost: $6.40/claim|Median: $9.10
0.7× median
83655Normal range

$49K

7,060 claims · 0.4%

Your Cost: $6.96/claim|Median: $10.49
0.7× median
99173Normal range

$35K

21K claims · 0.3%

Your Cost: $1.64/claim|Median: $2.16
0.8× median
87899Normal range

$29K

3,088 claims · 0.2%

Your Cost: $9.43/claim|Median: $7.65
1.2× median
87807Normal range

$24K

3,188 claims · 0.2%

Your Cost: $7.47/claim|Median: $10.06
0.7× median
85018Normal range

$15K

9,921 claims · 0.1%

Your Cost: $1.53/claim|Median: $1.71
0.9× median
99188Normal range

$14K

1,091 claims · 0.1%

Your Cost: $12.73/claim|Median: $12.80
1.0× median
96160Normal range

Patient-focused health risk assessment

$9K

9,143 claims · 0.1%

Your Cost: $0.97/claim|Median: $2.10
0.5× median
17110Normal range

Destruction of benign lesions, up to fourteen

$7K

144 claims · 0.1%

Your Cost: $46.88/claim|Median: $59.25
0.8× median
96161Normal range

$6K

1,576 claims · 0.0%

Your Cost: $3.70/claim|Median: $2.49
1.5× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$5K

4,273 claims · 0.0%

Your Cost: $1.11/claim|Median: $3.67
0.3× median
0071ATop 25%

$4K

98 claims · 0.0%

Your Cost: $45.09/claim|Median: $38.71
1.2× median
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